Gasserian Ganglion and Retrobulbar Nerve Block in the Treatment of Ophthalmic Postherpetic Neuralgia: A Case Report

Huang, Jie; Ni, Zhongge; Finch, Philip M.

doi:10.1111/papr.12547

Cited by 11 publications

(18 citation statements)

References 39 publications

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“…Further investigation is warranted to determine whether at the end of the treatment, just before withdrawing the trocar, slow injection of steroids and local anesthetics can reduce the postoperative pain increase. 28 , 29 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of CT-guided percutaneous pulsed radiofrequency treatment of the Gasserian ganglion in patients with medically intractable idiopathic trigeminal neuralgia

Lv¹,

Jia²,

Shen³

et al. 2018

JPR

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BackgroundThere is a lack of prospective studies for the long-term results of percutaneous pulsed radiofrequency (PRF) of the Gasserian ganglion in the treatment of patients with medically refractory trigeminal neuralgia (TN).Methods and resultsWe prospectively observed the outcomes of 28 idiopathic TN patients (between July 2013 and July 2016) who received CT-guided percutaneous PRF treatment of the Gasserian ganglion. All of the patients had stopped responding to drug therapy before PRF treatment. The effective treatment standard was a reduction in the pain numeric rating scale (NRS) by ≥50% after the procedure. The postoperative NRS score decreased gradually from preoperative 7.6±0.8 months to 1.5±2.4, 0.2±0.4, 0.2±0.4, 0.1±0.4, and 0.1±0.4 at 1, 3, and 6 months and 1 and 2 years after the PRF treatment. The response rates at 1, 3, and 6 months were 85.7%, and the rates at 12 months and 2 years were maintained at 78.6%. No serious side effects were observed.ConclusionCT-guided PRF invention is an effective and safe technique for medically intractable idiopathic TN patients. This minimally invasive alternative treatment has the potential as a first-line therapy for TN.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of CT-guided percutaneous pulsed radiofrequency treatment of the Gasserian ganglion in patients with medically intractable idiopathic trigeminal neuralgia

Lv¹,

Jia²,

Shen³

et al. 2018

JPR

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show abstract

“…The automatic PRF mode of the pain treatment generator was used, the temperature was 42°C, the pulsed frequency was 2 Hz, and the treatment was performed twice for 120 seconds continuously. After treatment, 0.7 mL of solution containing 1 mg dexamethasone sodium phosphate and 0.5 mL 1% plain lidocaine was slowly injected through the radiofrequency treatment trocar …”

Section: Methodsmentioning

confidence: 99%

“…After treatment, 0.7 mL of solution containing 1 mg dexamethasone sodium phosphate and 0.5 mL 1% plain lidocaine was slowly injected through the radiofrequency treatment trocar. 16,17…”

Section: Operationmentioning

confidence: 99%

Treatment of Refractory Idiopathic Supraorbital Neuralgia Using Percutaneous Pulsed Radiofrequency

Luo

2018

Pain Practice

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“…In the nerve block group, a radiofrequency generator will be set at the sensory stimulating mode, and the lowest frequency of 0.2 V will be used for 360 s sham PRF treatment (20), after which 1.4 mL of a mixture of 2 mg of dexamethasone sodium phosphate and 1 mL of 1% plain lidocaine will be slowly injected through the radiofrequency treatment trocar. Before the trocar is removed, 0.5 mL of normal saline will be injected (21,22). In the PRF group, the pain treatment generator (15,23,24) will be set to manual PRF mode, and the upper temperature limit will be set to 42°C.The PRF output voltage will then be gradually increased to the highest voltage the patient can tolerate, and the patient will be treated for 360 s. After the treatment, 1.4 mL of a mixture of 0.4 mL of normal saline and 1 mL of 1% lidocaine will be injected through the trocar.…”

Section: Investigation Of Prf In Tn: a Multicenter Double-blind Rctmentioning

confidence: 99%

Effectiveness and Safety of High-Voltage Pulsed Radiofrequency to Treat Patients with Primary Trigeminal Neuralgia: A Multicenter, Randomized, Double-Blind, Controlled Study Protocol

et al. 2018

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Background: Trigeminal neuralgia (TN) is a neurological syndrome characterized by paroxysmal, lightning-like, severe pain in the facial area innervated by the trigeminal nerve. Patients who do not respond well to drug treatment can undergo a nerve block, a traditional conservative treatment. Pulsed radiofrequency (PRF) is a nondestructive pain intervention technique. However, its treatment effectiveness for TN has rarely been reported and remains controversial among scholars. A recent single-center preliminary clinical study showed that high-voltage PRF was significantly effective in the treatment of TN. However, whether high-voltage PRF is a viable pain treatment option for TN patients who are unresponsive to drug treatment must still be confirmed with standardized clinical studies by utilizing conservative nerve block treatment as a control. Objective: To compare theeffectiveness and safety of high-voltage PRF and nerve block for primary TN patients who have failed to respond topharmacological treatment and who are seeking a better non-surgical treatment option. Study Design: Prospective, multicenter, randomized, double-blind, controlled clinical trial. Setting: Three interventional pain management centers in Beijing, China. Methods: The study will include 134 consecutive patients with primary TN who have failed to respond to drug treatment. The patients will be randomly assigned to 2 groups, the nerve block group and the PRF group. The nerve block group will be slowly injected with 1.4 mL of a mixture of dexamethasone and lidocaine after 360 s of sham PRF treatment, and 0.5 mL of normal saline will be administered before the needle is withdrawn. The PRF group will undergo 360 s of 42°C PRF treatment at the highest output voltage that the patients can tolerate, after which the patients will be injected with the same concentration and volume of lidocaine and normal saline that the nerve block group receives. The Barrow Neurological Institute (BNI) pain intensity scale will be used to assess the degree of pain relief before and after the treatment. Results: The effectiveness and safety of high-voltage PRF and nerve block to treat TN will be analyzed to determine significant differences in pain relief and functional improvement. The primary efficacy outcome measure is the response rate at one-year post-operation (BNI I-III/total number of cases*100%). Secondary efficacy outcome measures include the response rate at postoperative day 1, week 1, week 2, month 1, month 3, month 6 and year 2, the patient satisfaction score (PSS) at various time points, the dosage of antiepileptic drugs (milligrams per day), and information regarding patients with a BNI score of IV or V who switch to other therapies. Limitations: The effects of the waveform, treatment duration, frequency and other parameters of PRF deserve further investigation. Conclusions: This is the first multicenter, double-blind, randomized controlled study to compare the efficacy and safety of PRF and nerve block to treat TN patients who have failed to respond to drug treatment. Moreover, the value of PRF in TN treatment may need to be clinically clarified with evidence-based medical support and other advanced studies. Key words: Trigeminal neuralgia, effectiveness, safety, pulsed radiofrequency

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Gasserian Ganglion and Retrobulbar Nerve Block in the Treatment of Ophthalmic Postherpetic Neuralgia: A Case Report

Abstract: To our knowledge, this is the first reported case of ophthalmic division PHN successfully treated with a combination of trigeminal ganglion and retrobulbar nerve block using a local anesthetic agent and steroid for central and peripheral neural inflammatory processes.

Cited by 11 publications

References 39 publications

Efficacy and safety of CT-guided percutaneous pulsed radiofrequency treatment of the Gasserian ganglion in patients with medically intractable idiopathic trigeminal neuralgia

Efficacy and safety of CT-guided percutaneous pulsed radiofrequency treatment of the Gasserian ganglion in patients with medically intractable idiopathic trigeminal neuralgia

Treatment of Refractory Idiopathic Supraorbital Neuralgia Using Percutaneous Pulsed Radiofrequency

Effectiveness and Safety of High-Voltage Pulsed Radiofrequency to Treat Patients with Primary Trigeminal Neuralgia: A Multicenter, Randomized, Double-Blind, Controlled Study Protocol

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